Provider Demographics
NPI:1144525742
Name:SPRUILLE, CARLOTTE (LAC, CCGC)
Entity type:Individual
Prefix:MS
First Name:CARLOTTE
Middle Name:
Last Name:SPRUILLE
Suffix:
Gender:F
Credentials:LAC, CCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GORDON PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-5659
Mailing Address - Country:US
Mailing Address - Phone:504-616-3111
Mailing Address - Fax:
Practice Address - Street 1:1506 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-6512
Practice Address - Country:US
Practice Address - Phone:504-471-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)